1,351 research outputs found

    Chronic cough: new insights and future prospects

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    Chronic cough is defined in adults as a cough that lasts for ≥8 weeks. When it proves intractable to standard-of-care treatment, it can be referred to as refractory chronic cough (RCC). Chronic cough is now understood to be a condition of neural dysregulation. Chronic cough and RCC result in a serious, often unrecognized, disease burden, which forms the focus of the current review.The estimated global prevalence of chronic cough is 2-18%. Patients with chronic cough and RCC report many physical and psychological effects, which impair their quality of life. Chronic cough also has a significant economic burden for the patient and healthcare systems. RCC diagnosis and treatment are often delayed for many years as potential treatable triggers must be excluded first and a stepwise empirical therapeutic regimen is recommended.Evidence supporting most currently recommended treatments is limited. Many treatments do not address the underlying pathology, are used off-label, have limited efficacy and produce significant side-effects. There is therefore a significant unmet need for alternative therapies for RCC that target the underlying disease mechanisms. Early clinical data suggest that antagonists of the purinergic P2X3 receptor, an important mediator of RCC, are promising, though more evidence is needed

    Estimating and modeling the dynamics of the intensity of infection with Schistosoma japonicum in villagers of Leyte, Philippines. Part II: Intensity-specific transmission of S. japonicum. The schistosomiasis transmission and ecology project

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    A dynamic model of Schistosoma japonicum transmission is presented that incorporates effects of infection intensity, age, and sex. We use four infection intensity classes to investigate the impact of ecologic changes and public health interventions on the burden of infection within communities. Age- and sex-specific infection data from three disease-endemic villages in the Philippines are used to estimate the parameters of the model. The model gives good qualitative agreement with observed fecal egg counts adjusted for the accuracy of the Kato-Katz examination. Our results suggest that differences in infection burden between villages are caused by differences in both the infection process and the recovery process in humans. We describe the potential impact of mass treatment of all humans on the numbers with high infection. Furthermore, we show that a sudden reduction in snail population size would affect high prevalence and low prevalence communities in different ways. Copyright © 2005 by The American Society of Tropical Medicine and Hygiene.published_or_final_versio

    Socio-cultural norms of body size in Westerners and Polynesians affect heart rate variability and emotion during social interactions

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    The perception of body size and thus weight-related stigmatization vary between cultures. Both are stronger in Western than in Polynesian societies. Negative emotional experiences alter one’s behavioral, psychological, and physiological reactions in social interactions. This study compared affective and autonomic nervous system responses to social interactions in Germany and American Samoa, two societies with different body-size related norms. German (n = 55) and Samoan (n = 56) volunteers with and without obesity participated in a virtual ball-tossing game that comprised episodes of social inclusion and social exclusion. During the experiment, heart rate was measured and parasympathetic activity (i.e., high-frequency heart rate variability) was analyzed. We found differences in both emotional experience and autonomic cardio-regulation between the two cultures: during social inclusion, Germans but not Samoans showed increased parasympathetic activity. In Germans with obesity, this increase was related to a more negative body image (comprising high rates of weight-related teasing). During social exclusion, Samoans showed parasympathetic withdrawal regardless of obesity status, while Germans with obesity showed a stronger increase in parasympathetic activity than lean Germans. Furthermore, we found fewer obesity-related differences in emotional arousal after social exclusion in Samoans as compared to Germans. Investigating the interplay of socio-cultural, psychological, and biological aspects, our results suggest influences of body size-related socio-cultural norms on parasympathetic cardio-regulation and negative emotions during social interactions

    Redefining disease emergence to improve prioritization and macro-ecological analyses

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    AbstractMicrobial infections are as old as the hosts they sicken, but interest in the emergence of pathogens and the diseases they cause has been accelerating rapidly. The term ‘emerging infectious disease’ was coined in the mid-1900s to describe changes in disease dynamics in the modern era. Both the term and the phenomena it is meant to characterize have evolved and diversified over time, leading to inconsistencies and confusion. Here, we review the evolution of the term ‘emerging infectious disease’ (EID) in the literature as applied to human hosts. We examine the pathways (e.g., speciation or strain differentiation in the causative agent vs. rapid geographic expansion of an existing pathogen) by which diseases emerge. We propose a new framework for disease and pathogen emergence to improve prioritization. And we illustrate how the operational definition of an EID affects conclusions concerning the pathways by which diseases emerge and the ecological and socioeconomic drivers that elicit emergence. As EIDs appear to be increasing globally, and resources for science level off or decline, the research community is pushed to prioritize its focus on the most threatening diseases, riskiest potential pathogens, and the places they occur. The working definition of emerging infectious diseases and pathogens plays a crucial role in prioritization, but we argue that the current definitions may be impeding these efforts. We propose a new framework for classifying pathogens and diseases as “emerging” that distinguishes EIDs from emerging pathogens and novel potential pathogens. We suggest prioritization of: 1) EIDs for adaptation and mitigation, 2) emerging pathogens for preventive measures, and 3) novel potential pathogens for intensive surveillance

    Improving Striping Operations through System Optimization - Phase 2

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    Striping operations generate a significant workload for MoDOT maintenance operations. The requirement for each striping crew to replenish its stock of paint and other consumable items from a bulk storage facility, along with the necessity to make several passes on most of the routes to stripe all the lines on that road, introduce the potential for inefficiencies in the form of deadhead miles that striping crew vehicles must travel while not actively applying pavement markings. These inefficiencies generate unnecessary travel, wasted time, and vehicle wear. Phase 2 updates a 2015 project that developed a decision support tool for scheduling and routing road striping operations. The updates presented in the final report improve the optimization model, which generates more user-friendly outputs
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